title: The effect of the late 2000s financial crisis on suicides in Spain: an interrupted time-series analysis.
abstract: BACKGROUND
  The current financial crisis is having a major impact on European economies, especially that of Spain. Past evidence suggests that adverse macro-economic conditions exacerbate mental illness, but evidence from the current crisis is limited. This study analyses the association between the financial crisis and suicide rates in Spain.
  
  
  METHODS
  An interrupted time-series analysis of national suicides data between 2005 and 2010 was used to establish whether there has been any deviation in the underlying trend in suicide rates associated with the financial crisis. Segmented regression with a seasonally adjusted quasi-Poisson model was used for the analysis. Stratified analyses were performed to establish whether the effect of the crisis on suicides varied by region, sex and age group.
  
  
  RESULTS
  The mean monthly suicide rate in Spain during the study period was 0.61 per 100 000 with an underlying trend of a 0.3% decrease per month. We found an 8.0% increase in the suicide rate above this underlying trend since the financial crisis (95% CI: 1.009-1.156; P = 0.03); this was robust to sensitivity analysis. A control analysis showed no change in deaths from accidental falls associated with the crisis. Stratified analyses suggested that the association between the crisis and suicide rates is greatest in the Mediterranean and Northern areas, in males and amongst those of working age.
  
  
  CONCLUSIONS
  The financial crisis in Spain has been associated with a relative increase in suicides. Males and those of working age may be at particular risk of suicide associated with the crisis and may benefit from targeted interventions.
authors.affiliation: 1 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
authors.forename: James A
authors.initials: JA
authors.lastname: Lopez Bernal
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasparrini
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Artundo
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D057172:Economic Recession; D005260:Female; D062305:Geographic Mapping; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult